(1) "Centers for Medicare and Medicaid Services (CMS) Top 20" means the list of National Drug Codes (NDCs) as determined under Section 1927(a)(7)(B) of the Social Security Act requiring the Secretary of CMS to publish a list of the 20 multiple source physician administered drugs with the highest dollar volume dispensed under the Medicaid program.

(2) "Healthcare common procedures coding system (HCPCS)" means the national uniform coding method maintained by the CMS that incorporates the American Medical Association (AMA) Physicians Current Procedural Terminology (CPT) and the three HCPCS unique coding levels, I, II, and III.

(a) For purposes of physician administered drugs, HCPCS refers to billable codes that may be cross-walked to NDCs.

(3) "National Drug Codes (NDC)" means an 11 digit numerical code that identifies the manufacturer, drug, and package size assigned by the Federal Drug Administration (FDA).

(4) "Physician administered drugs" means covered outpatient drugs under section 1927(k)(2) of the Social Security Act that are typically furnished incident to a physician's service.

(a) These drugs are injectable or intravenous drugs administered by a medical professional in a physician's office or other outpatient clinical setting.

(b) Reimbursement for physician administered drugs is allowed only if the drug is a covered drug under 42 USC 1396r-8.